Monday, August 31, 2009

Dan at Gay Patriot has an interesting post on how Ted Kennedy saved a girl from the Soviet medical system, which could not treat her disease. Fair enough, Teddy saved a girl (I'm resisting the urge to mention .... well you know).

I am familiar with the Soviet medical system, at least as it existed in the late 1970s and early 1980s, when I studied in Moscow. There was free and universal medical care for all. But the care sucked (that's a Russian medical term).

Doctors were held in low esteem, and there was a flourishing black market in private medical care for the same reasons there was a flourishing black market in just about everything. Central planning doesn't work, whether it's in medicine or anything else. What don't you understand about the failure of communism?

So, getting back to Ted, good deed done. But that misses the point.

When we beat the profit motive out of medicine so that the best and brightest go into other professions; when we homogenize care to the lowest common denominator; when we create planned shortages; when we demean doctors as people who only want their patients to get unnecessary surgeries; when politicians play doctor (red pill or blue pill?); when we have re-created the Soviet medical system in the name of equality and fairness ...

This is the second in a series of posts analyzing randomly selected provisions in HR3200, the House Democratic health care restructuring bill. In the prior post, I examined the almost incomprehensible section 1721 concerning payments to primary care practitioners.

The page selected for this post, using the dartboard method, is page 692 of the House Bill which contains the final paragraph of Sec. 1613, "Enhanced Penalties for Delaying Inspections." As set forth below, the title is apt. The section gives the government a huge hammer, in the way of sizable daily penalties, to ensure that providers and suppliers to federal health care programs permit federal officials access for inspections.

Section 1613 amends Section 1128A(a) of the Social Security Act (42 U.S.C. 1320a–7a(a)), "as amended by sections 1611 [enhanced penalties for false statements on provider or supplier enrollment applications] and 1612 [false statements in support of a false claim]" of the House Bill, by adding penalties where a person:

10) fails to grant timely access, upon reasonable request (as defined by the Secretary in regulations), to the Inspector General of the Department of Health and Human Services, for the purpose of audits, investigations, evaluations, or other statutory functions of the Inspector General of the Department of Health and Human Services;’’

Looking at the cross-references, this is part of increased fraud penalties in the legislation, in this case having to do with providers and suppliers under any federal health care program. Section 1613 imposes penalties for any provider or supplier who refuses to grant access for an inspection under applicable regulations.

But determining the exact application is very tricky. The proposed amendment says that the penalty is determined using the following formula:

(4) in the matter following paragraph (10), as inserted by paragraph (3)—

(A) by striking ‘‘or’’ after ‘‘$50,000 for each such act,’’;and(B) by inserting ‘‘, or in cases under paragraph (10), $15,000 for each day of the failure described in such paragraph’’ after ‘‘false record or statement’’.

It is hard to figure out this language, because of the use of the words “in the matter” and the reference to “paragraph (3).” There may be a logic to this wording, but it is not obvious. I think it means that penalties for violation of this new paragraph 10 will be $15,000 for each day on non-compliance. So if someone delays for a week, the penalties would be $105,000.

Unlike the provisions of section 1721, examined in the prior post, these penalty provisions are not incomprehensible. But they are hard to follow, requiring a time-consuming comparison of existing statutes and other provisions in the House Bill.

This provision creates a new inspection regime giving the government access to a supplier or provider’s premises, and gives the government a very heavy hammer to enforce compliance with the government's inspection requirements. I don't know enough about these specific types of inspections to determine if they exist elsewhere in the law, but the drafters obviously felt the need to add these access requirements.

Is this a good thing? The positive is that fraud in government health care programs is rampant, so anything which gives the government additional investigative tools could be helpful.

The downside is that government is given substantial new powers, under threat of heavy daily fines, allowing it access as, if, and when it deems necessary. Certainly, one can imagine scenarios where a person believes the government is acting unreasonably in requesting access, but the fear of daily penalties would put such person at severe financial risk.

VERDICT: The lesson would be that if you do business with the government health care system, your business is an open book subject to inspection and access at any time.

--------------------------------------------This post is cross-posted at American Thinker.

Sunday, August 30, 2009

No one has been able to get a full grasp on the scope of the health care system restructuring proposed by the Democrats. I have written extensively on some of the more interesting tax provisions, but I only have scratched the surface. The pending House and Senate HELP Committee bills are the size of a major city phone book.

So I decided to use an approach I have seen on television, where a reporter randomly throws a dart at a map of the United States, then pulls the phone book for whatever location was selected, picks a page and person randomly out of the phone book, then visits the person to get his or her life story. Often the result is interesting, although sometimes quite boring.

For the Democratic proposals, I'm going to work off of HR3200, which also is known as the ‘‘America’s Affordable Health Choices Act of 2009,’’ but for current purposes, the "House Bill." I've chosen the House Bill, rather than the Senate version, because the House Bill is just over 1018 pages, which works better with my random selection method. The Senate bill is 615 pages, and contains some real doozies, so I hate to pass up the opportunity, but the House Bill will work better.

I will look at my Sitemeter page count for seven straight days, and whatever the last three digits are on the page count, I will turn to that page in the House Bill. I will use whichever section of the House Bill appears at the top of the page, even if the section starts on prior pages.

I will try to explain what the section and provisions on the page mean. There is no guarantee that I will be able to do so, as some of these provisions may be incomprehensible. The fact that a particular page or section is incomprehensible is interesting in itself, considering there are over 1000 pages. I invite readers to post comments with alternative explanations, and corrections to my analysis are invited. Here goes.

---------

For my first Sitemeter check, the page view count was 1,171,780, so I turned to page 780 in the House Bill.

The top of page 780 finishes up Sec. 1721, of the House Bill, "Payments to primary care practitioners." This section sets forth amendments to the Social Security Act (42 U.S.C. 14 1396b(a)(13), by adding a new paragraph "(C)" as follows:

(C) payment for primary care services (as defined in section 1848(j)(5)(A), but applied without regard to clause (ii) thereof) furnished by physicians (or for services furnished by other health care professionals that would be primary care services under such section if furnished by a physician) at a rate not less than 80 percent of the payment rate applicable to such services and physicians or professionals (as the case may be) under part B of title XVIII for services furnished in 2010, 90 percent of such rate for services and physicians (or professionals) furnished in 2011, and 100 percent of such payment rate for services and physicians (or professionals) furnished in 2012 or a subsequent year;

This section also adds provisions relating to Medicaid Managed Care Programs as part of this new section "(C)":

Section 1923(f) of such Act (42 U.S.C. 1396u–2(f)) is amended—(A) in the heading, by adding at the end the following: ‘‘; ADEQUACY OF PAYMENT FOR PRIMARY CARE SERVICES’’; and (B) by inserting before the period at the end the following: ‘‘and, in the case of primary care services described in section 1902(a)(13)(C), consistent with the minimum payment rates specified in such section (regardless of the manner in which such payments are made, including in the form of capitation or partial capitation)’’.

In case you were wondering, I already regret this undertaking. I don't know if I can keep this up for seven straight days. This section, what it means, and what it does, is all but incomprehensible. And to think, I could be weeding the garden.

But whatever it means, on page 780 of the House Bill, the Democrats propose to increase payments using "100% FMAP" (Federal Medical Assistance Percentages) under this new section "(C)":

(3)(A) The portion of the amounts expended for medical assistance for services described in section 1902(a)(13)(C) furnished on or after January 1, 2010, that is attributable to the amount by which the minimum payment rate required under such section (or, by application, section 1932(f)) exceeds the payment rate applicable to such services under the State plan as of June 16, 2009.

(B) Subparagraphs (A) shall not be construed as preventing the payment of Federal financial participation based on the Federal medical assistance percentage for amounts in excess of those specified under such subparagraphs.

VERDICT: Close to incomprehensible. I think this means that there will be an increase in reimbursements to states for payments to primary care physicians under Medicaid. I could be wrong. There are so many cross-references, that it would take hours to figure out the full implications and all the conditions to which such payments are made, much less the source of revenue for the payments.

What this section does show is the density of the House Bill. Understanding just this single provision is a daunting task. Call it the banality of bureaucracy. Someone, be it a lobbyist or staffer or both, spent an enormous amount of time writing this dense text to accomplish something which is not explained in a form almost anyone could understand or comprehend.

Saturday, August 29, 2009

Mathew Yglesias is one of the leading liberal bloggers pushing ObamaCare KennedyCare. Since every Senate vote counts, Yglesias and other KennedyCare promoters need to justify the Massachusetts legislature's pending flip-flop on how to select a successor to Ted Kennedy, to allow the Democratic Governor to appoint a temporary (Democratic) replacement.

Under current Massachusetts law, there must be a special election and the Governor has no power of appointment. The current law is a result of Democrats changing the law in 2004 so that then Republican Governor Mitt Romney would not appoint a replacement for John Kerry in the event Kerry were elected President.

This flip-flop makes clear that those Democrats pushing to change the law once again are rank hypocrites who play games with the law for purely political purposes. These games prove why we should not trust politicians, particularly the current Democratic leadership, with our health care system.

Even the Boston Globe, which supports changing the law again, does not try to excuse what happened in 2004:

Some state lawmakers fear they will look like hypocrites if they change the law to allow for such an appointment. In fact, they will. The shift in 2004 was indeed a naked effort to block former governor Romney from appointing a fellow Republican if Senator John Kerry were to win the presidency. Kennedy himself played a behind-the-scenes role in the political sleight of hand. A Globe editorial in March 2004 took Romney’s side and urged the legislative leadership “to scuttle this undeniably partisan bill.’’ The bill passed, and its dispiriting effects are now in full force. But sticking with a bad position for the sake of consistency or to save face would hardly serve the residents of Massachusetts.

But Yglesias has figured out a way to spin 2004 and 2008 so that people who criticize the Democrats for changing the law are the ones who are hypocritical. In a post titled Strange Hypocrisy, Yglesias proposes that the legislature use whatever process best replaces the existing Senator with a person who best reflects what the voters really want:

This is being described in some quarters as “hypocritical,” which really strikes me as silly. The underlying principle here is that the outcome of senatorial vacancies should reflect the underlying preferences of the people of Massachusetts. You could imagine a different state in which the parties are much more competitive in which this bobbing and weaving really was nothing more than a transient majority in the state legislature entrenching its power. But does anyone seriously dispute that the Massachusetts electorate prefers (a) to be represented in the U.S. Senate and (b) congressional Democrats? It’s been over ten years since the Bay State sent a Republican to Congress, and the last Republican Senator lost in 1978.

But who will determine what are the "underlying preferences" of the voters, if not the voters themselves? What if the voters really want a change? Under Yglesias' theory, the Governor would have to appoint a proxy for the deceased Senator, someone who will channel the deceased Senator in a seance-like manner, regardless of the fact that every Senator -- appointed or elected -- is free to vote his or her conscience regardless of campaign positions and promises.

Yglesias could take the Boston Globe approach, and just admit that the Democrats are being hypocrites, but to allow such an admission would call into question why such hypocrites should be entrusted with our health care system. In trying to find a consistency where none exists, Yglesias unwittingly exposes the pure politics behind much Democratic rhetoric on health care restructuring.

Ezra Klein, another leading pro-KennedyCare blogger, takes Yglesias' concept one step farther, calling on each Senator to have a "living will" containing the name of his or her successor:

It's weird to give governors any autonomous role in this process. If I were writing these laws, every senator would have a "living will" of sorts that names an interim replacement in the event of their incapacitation, and those interim senators would not be able to compete in the subsequent election. And that's what Massachusetts should do. Let Patrick pick the interim senator this year, as Kennedy can't do it, but write the legislation such that it won't need to be changed every few cycles.

The fact is that good arguments can be made for allowing a temporary appointment, or a quick special election, or some combination. There is no right or wrong.

What is wrong, however, is to change the rules mid-game so as to ensure one party's predominance. It is hypocrisy plain and simple. The fact that two leading liberal proponents of KennedyCare refuse to call it as such demonstrates why we cannot trust our most intimate health care decisions to the government in general, to politicians in particular, and most of all, to the liberal intelligentsia.

You may be promised now that you can "keep your doctor" or "keep your health insurance," but who is to prevent the rules from being changed for political purposes after the fact? People who would change the law in 2004 to benefit the Democrats, then propose changing it again in 2008 to benefit the Democrats, cannot be trusted.

Also fun is this one from my favorite not-quite-30 deep thinker, Matthew Yglesias. He’s explaining why Kenedy’s effort to prevent a Massachusets GOP governor from being able to appoint John Kerry’s replacement, and Kennedy’s deathbed effort to give appointment power back to the current Democratic governor, is not rank hypocrisy and cynical anti-democratic manipulation. The lefty lad explains that because Massachusetts politics are dominated by Democrats, it’s OK for Democrats to dominate Massachusetts politics. His explanation fails to acount for the 16 consecutive years that a succession of Republicans held the governor’s office .. which is elected statewide, as it happens … and the fact that both Kennedy and Kerry generally have lost about one-third of the votes in this bluest of states.

Friday, August 28, 2009

Almost forgot that Bill Ayers glorified the killer of Robert Kennedy, but thanks to a commenter at Tim Blair's blog, it's time to remember:

“Is now the time to remind everyone,” emails KP, “that Obama’s babysitters Ayers and Dohrn dedicated their communist manifesto to Robert Kennedy’s assassin, amongst others?”

Even this columnist at The Nation didn't buy Ayer's excuses for the dedication:

It's hard to imagine anyone now applauding the Manson murders, as Dohrn notoriously did in l969, or dedicating a manifesto to, among others, Sirhan Sirhan. But just because it's ancient history doesn't mean you get to rewrite it to make yourself look good, just another idealistic young person upset about the war and racism.

Barack Obama is on vacation. That's fine. It's a high-pressure job, and a little relaxation is a good thing. But White House Deputy Press Secretary Bill Burton is not doing such a great job substituting for Press Secretary Robert Gibbs.

In defending Obama's plans for a second vacation, Burton said that Obama needs a "break from his vacation." And Burton went on to defend the vacation-from-a-vacation with this point:

"As I recall, the previous president [took] quite a bit of vacation himself, and I don't think anyone bemoaned that."

Thursday, August 27, 2009

CNN and MSNBC have been covering the Ted Kennedy death virtually non-stop. But it's not working out so well, per L.A. Times:

Fox News maintained its top ranking among the cable news channels Wednesday as its competitors turned most of their coverage over to the death of Sen. Edward Kennedy. The event didn't prove to be a major draw for viewers, however. Fox, which covered the story in a more limited fashion, drew an average of 1.37 million viewers throughout the entire day and 2.67 million viewers during prime time, according to Nielsen Media Research.

CNN, which usually dominates during major breaking news events, averaged 711,000 viewers overall and 1.19 million viewers in prime time. MSNBC pulled in 506,000 viewers throughout the day and 984,000 in prime time.

In the key 25- to 54-year-old advertising demographic, Fox had double the audience of its competitors in prime time, averaging 736,000 viewers. CNN and MSNBC were effectively tied, with 321,000 and 318,000, respectively.

So, if people are not particularly interested in watching the Kennedy-death television coverage, what does that say about the likelihood liberal Democrats can exploit Kennedy's death to rally the nation around a Kennedy-care bill?

Maybe it's a sign that the Kennedy name does not mean much outside of the circles who supported Kennedy-care before it was called Kennedy-care.

Steve Benen at Washington Monthly's Political Animal blog complains that conservatives are working off some pre-determined script as to Ted Kennedy's death:

"It looks like word went out yesterday about what leading conservative voices should say about Ted Kennedy's death: complain about the memorial service that hasn't happened yet."

Benen then cites several examples, with quotes from Sean Hannity, Instapundit, Allahpundit, and Kathryn Jean Lopez.

But click on the link in Benen's post, and you will see that he is parroting Media Matters -- the source of so much of what ends up in left-wing blogs -- for his post. Bennin appears to be working off of the Media Matter's script for how to respond to what conservatives are saying about Ted Kennedy's death, namely, to accuse conservatives of being scripted.

So someone who is working off of the Media Matters' script is complaining that conservatives are scripted. Classic.

Four years ago, someone published photos of a guy dancing on Ronald Reagan's grave. The photos were posted also at the "Princess Sparkle" blog, with this commentary:

I've never met the sassy youngster in the above photos, but he's a Pony Pal™ by default. What's he doing? Why, he's dancing --and cutting a mean ol' rug from the looks of it-- on Ronald Reagan's grave. The intrepid discoholic then triumphantly posted the photos on this message board, and now Wing-Nut Daily has her panties all in a bunch over it. And they're out for blood. Or jail. Or an anti-Republican-grave-desecration amendment, or something. Just wait 'til Anne Coulter hears about this, then the fur will really fly.

And to top it off, the blog post featured the same guy pissing on Nixon's grave.

So when you hearpeoplecomplain that Republicans are dancing on Ted Kennedy's grave, figuratively speaking, let's (1) hope it doesn't happen, (2) keep in mind that it is Democrats who are using Kennedy's death for political purposes, and (3) remember it happened to Reagan, literally.

As of August 24, 2009, the two Democratic draft health care restructuring bills were horrible monstrosities which contained a myriad of pernicious tax and other provisions which put at risk the well-being of hundreds of millions of Americans while doing precious little to help the 10-15 million chronically uninsured. For the reasons repeatedly posted here, the bills stank and had little chance of passing due to opposition from Republicans, Independents, and moderate Democrats.

On August 25, 2009, Ted Kennedy died.

On August 26, 2009, liberal Democrats decided to use Kennedy's death as a rallying call to get the bills passed.

As of August 27, 2009, the two draft health care restructuring bills still stink. Kennedy's death may have changed the politics, but it didn't change the bills.

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Wednesday, August 26, 2009

The Telegraph newspaper in Britain has details on a new report just released by the Patients Association which reveals one aspect of the health care crisis in Britain:

In the last six years, the Patients Association claims hundreds of thousands have suffered from poor standards of nursing, often with 'neglectful, demeaning, painful and sometimes downright cruel' treatment.

The charity has disclosed a horrifying catalogue of elderly people left in pain, in soiled bed clothes, denied adequate food and drink, and suffering from repeatedly cancelled operations, missed diagnoses and dismissive staff.

The Patients Association said the dossier proves that while the scale of the scandal at Mid-Staffordshire NHS Foundation Trust - where up to 1,200 people died through failings in urgent care - was a one off, there are repeated examples they have uncovered of the same appalling standards throughout the NHS.

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How to react to Ted Kennedy's death? There certainly is an initial inclination to react the way so many left-wing blogs reacted to the death of Robert Novak, such as this post at the prominent Crooks and Liars:

Novak will perhaps be best remembered -- if at all -- as one of the most compulsive professional liars to have wormed his way inside the Beltway, and that's saying something.

No, will not go there. But I will take to task the people who are seeking to use Kennedy's death to their political advantage, such as this call by Balloon Juice:

" it’s time to come back after Labor Day with a single coherent Senator Edward M. Kennedy Health Care Reform Bill, and to twist whatever arms, ears, or other parts are necessary to get a good strong comprehensive bill passed and signed, NOW. We owe the memory of a great man no less."

This theme of naming a bill after Kennedy is sure to pick up steam, as Democrats are desperate to do anything to overcome public opposition on the merits. Witness this San Francisco Chronicle column today:

There would be no more fitting tribute to the passing of Ted Kennedy, than to pass a health-care reform bill by early fall.

Strange, when Rush Limbaugh used the phrase "Kennedy Memorial Health Bill," [in predicting how Democrats would use Kennedy's death] he was harshly criticized. But that was back in March, on the heels of the stimulus bill, when passage of a Democratic health care restructuring bill seemed like a certainty.

Now that passage of Democratic health care restructuring seems much less likely, I guess it is okay to invoke Kennedy's name.

Tuesday, August 25, 2009

More tax mischief surfaces, once again, when the pending House health care bill is squeezed. This analysis by a tax lawyer at the law firm of Cleary Gottlieb shows that when various cross-referenced provisions are read together, the House bill limits the discretion of the IRS to waive penalties for honest taxpayer mistakes:

One [provision] would change the law to mandate that the Internal Revenue Service slap penalties on honest but errant taxpayers.

Under current law, taxpayers who lose an argument with the IRS can generally avoid penalties by showing they tried in good faith to comply with the tax law. In a broad range of circumstances, the health-care bill would change the law to impose strict liability penalties for income-tax underpayments, meaning that taxpayers will no longer have the luxury of making an honest mistake. The ability of even the IRS to waive penalties in sympathetic cases would be sharply curtailed.

The proposed changes in penalty rules have largely escaped notice because they are buried in a part of the bill that purports to deal with abusive tax shelters. They are barely mentioned in the Ways and Means Committee summary. Their inclusion in the bill underscores the need to read it closely. If anyone had doubts about the value of loading the text of the bill into a wheelbarrow and bringing it to the beach this August, the proposed changes to tax penalties should dispel them.

Sorry, but we should not have to load any piece of legislation into a wheelbarrow and take it to the beach, just to figure out what is in there. And to think that the President wanted this passed prior to the August recess.

Remember when Tea Parties and health care protests were derided as AstroTurf because some conservative groups gave logistical support? So what do you call it when the Democratic National Committee "organizes" and "plans" 500 protests, including the use of "professionally staffed" protests? From Politico:

Faced with a souring public mood on health care reform, Democrats and their supporters are launching a national grassroots push Wednesday to show lawmakers that the majority of Americans still support overhauling the system.

Reform supporters are planning to hold more than 500 events between Wednesday and when lawmakers return to Washington Sept. 8, ranging from neighborhood organized phone banks to professionally staffed rallies with hundreds of people.

The Democratic National Committee and its grassroots arm, Organizing for America, are helping to organize the effort along with the Health Care for America Now, a group pushing to create government-run insurance plan.

How does one "launch" a "grassroots" effort? Isn't that a contradiction in terms?

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Widespread abuse has been alleged, including one incident when they threatened a detainee "with a chainsaw as his autistic daughter looked on," another where they used cattle prods on detainees' genitals, another where they put a gun against a detainee's head, another where they slammed a handcuffed detainee's face into the ground.

A system fostering a pervasive atmosphere of abuse "without fear of punishment." Over 10,000 complaints of abuse in just two years, but only 19 disciplinary actions. And the abuse was covered up at the highest level.

Not at Gitmo. Not at black sites. Not at Abu Ghraib or Bagram.

In Chicago. "Allegedly."

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Monday, August 24, 2009

I can't keep up with all the ways in which this administration is failing. From the health care restructuring proposals gone sour, to the slippage in Iraq and Afghanistan, to the appeasement of Hugo Chavez and Iran and the bullying of Honduras, to the end of the special relationship with Israel, to the burgeoning budget deficits, to the unraveling of our intelligence capabilities, to the likely double-dip recession, to the mounting job losses, to the stimulus boondoggle, and on and on.

I just can't keep up with all the failures. And it's getting me worried that I may have been more prescient than I had expected in my predictions of what would happen when the speculative bubble of hope and change burst. And it's more than a little scary.

Sunday, August 23, 2009

A good example of how far off course Democrats in Congress have strayed on the issue of health care reform, are provisions in the Senate HELP Committee draft bill creating rules and regulations governing food disclosures at fast food restaurants and in vending machines.

Titled the Affordable Health Choices Act, the Senate draft bill amends the Federal Food, Drug and Cosmetic Act to require food nutritional disclosures at fast food restaurants, similar to the disclosures currently required on packaged food. Under section 325 of the Senate bill (starting at p. 399), any fast food chain with 20 locations and a standardized menu would have to display "in a clear and conspicuous manner" nutrition and calorie information. The information must be "adjacent" to each menu item, and the menu must contain

a succinct statement concerning suggested daily caloric intake, as specified by the Secretary by regulation and posted prominently on the menu and designed to enable the public to understand, in the context of a total daily diet, the significance of the caloric information that is provided on the menu...

But what about drive through windows? The information must be displayed on the drive through menu board. Salad bars and buffets? The information must be placed next to each item. Happy meals and other combos? Hmmm.... that's a problem, so the government needs to promulgate rules and regulations to figure out what kind of signage is needed:

The Secretary shall establish by regulation standards for determining and disclosing the nutrient content for standard menu items that come in different flavors, varieties, or combinations, but which are listed as a single menu item, such as soft drinks, ice cream, pizza, doughnuts, or children’s combination meals, through means determined by the Secretary, including ranges, averages, or other methods.

But wait, surely the vending machines of the world are safe from signage. Nope, owners of 20 or more vending machines will have to post signage with the nutritional and caloric content of every item in the vending machine:

[T]he vending machine operator shall provide a sign in close proximity to each article of food or the selection button that includes a clear and conspicuous statement disclosing the number of calories contained in the article.

There is nothing wrong with informing consumers of meaningful information, but these provisions demonstrate how far down the food chain (pun intended) the government will go to impose government control. Signage at drive through lanes and vending machines is so ineffectual as to be laughable.

Is it really necessary to have a sign with the Snickers bar nutritional information posted at a vending machine? Does anyone ordering Twinkies for $1.25 think they are getting anything other than a sugar high? Can't government just leave us, and our vending machines, alone for once?

Saturday, August 22, 2009

The House and Senate draft bills for health care restructuring are so odious that they are beyond repair.

It's nice that Max Baucus and some others are trying to squeeze some of the disastrous provisions out of the bills, but it is a waste of time. Even if the left-wing of the Democratic Party were to allow compromise, there is so much wrong with the current proposals, so many nuggets of bureaucratic deviousness hidden in hundreds of obscure, often cross-referenced, provisions, that it is like squeezing soap from a sponge. Every time you think it is all gone, another squeeze brings more of the mischief to the surface.

Here are links to a few of my prior posts exposing just some of the truly hideous aspects of the current bills:

Find a relatively small number of reform (not restructuring) provisions on which most people agree. On the insurance side, create a national insurance market, improve insurance portability so that people do not lose their coverage when they lose a job, create a pool for hard-to-insure or uninsurable patients and markets for low-cost catastrophic insurance so that no one faces bankruptcy from health care bills.

On the cost side, introduce provisions, such as easy-to-use health savings accounts, which give consumers an incentive to price and quality shop for health services much as they price and quality shop for other professional services and a host of consumer products. In the face of the consumer, medical providers will have an incentive to compete as to quality and cost.

Create tens of millions of private health care cost czars who make their own cost and quality decisions as to their own lives with their own money. Maintain the current safety net for those who through no fault of their own are unable to provide for themselves, but keep the focus on shrinking the need for a safety net through insurance and cost reforms.

And above all, first do no harm to the hundreds of millions of Americans who have insurance coverage and health care services with which they are happy. Take things one step at a time by starting on proposals on which there is widespread consensus, rather than on a grand plan to restructure society based on provisions on which there is widespread disagreement.

The Democratic health care sponge is so smelly and rancid that we have to find a different path forward.

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Scrolling through Doug Ross' blog, Director Blue, reminded me of a name from the past who seems to have escaped mainstream media scrutiny, much less responsibility, for two of the largest fiascos in our recent history, the intelligence failures which led to 9/11 and the Fannie Mae credit crisis:

So where is Jamie Gorelick today, and what is she doing? Turns out she's in private law practice helping clients navigate the government regulatory structure.

According to the NY Times, Gorelick was a key player in Barack Obama's transition team (shocking), was considered for Attorney General, and played her political cards right:

She contributed $10,000 to Mr. Obama’s presidential political action committee in August, after his nomination was all but assured.

And much like Barbara Boxer, the Times noted Gorelick doesn't like to be called Ma'am:

“You know someone respected you if they called you ‘sir,’ ” Ms. Gorelick said, alluding to the glass ceiling at the Pentagon, where she worked as general counsel in the 1990s. “ ‘Ma’am’ is what you call your mom.”

Gorelick has donated money in the past few months to key Democrats, including at least three on the Senate Judiciary Committee, including Pat Leahy, Sheldon Whitehouse and Al Franken. Oh, and she's part of a team pushing for appointment of D.C. judge Vanessa Ruiz to the federal Court of Appeals, which of course would involve a confirmation proceeding at the Senate Judiciary Committee before Leahy, Whitehouse and Franken.

And there's more. Gorelick, who was instrumental in the Fannie Mae disaster, has been hired by Sallie Mae (the student loan agency) as a lobbyist:

Sallie Mae's key hire was Jamie Gorelick, a former deputy attorney general in the Clinton administration, who signed on in February to lobby White House and Education Department officials on student-loan issues. Gorelick is a partner in the Washington law firm of Wilmer, Cutler, Pickering, Hale and Dorr, which billed Sallie Mae $270,000 for its work in the first half of 2009.

In such capacity, Gorelick will be dealing with the House Financial Services Committee Chairman Barney Frank, to whom she donated money in the last election.

Gorelick has made out just fine from her years in government. As for the rest of us, meh.

As much attention as the draft health care restructuring bills have received, so much has been missed in the thousands of pages of proposed legislation. It is not an exaggeration to say that these proposals create numerous and layered levels of new bureaucracies, on top of the expansion of existing layers of government.

The draft bill proposed by the Senate HELP Committee creates the following new bureaucracies. This is just a sample, and is not a complete list:

Deep within the text there are innumerable new studies, rulemaking requirements, grants, programs, and other provisions which will expand existing bureaucracies. And this is just the Senate draft, which is barely half as long as the House version. Here are some examples (not a complete list) from the Senate draft of grants to fund private bureaucracies:

Tom Ridge's bombshell -- the allegation that he felt political pressure to raise the threat level in the run-up to the 2004 election -- is not the real bombshell. The real story here is that Tom Ridge has joined Meghan McCain in the freakish side-show of Republicans in name only who seek to profit from re-writing history in the hope they will curry favor with the mainstream media and liberal Democrats.

Ridge's suspicions, and that's all they were, of a political motivation for raising the threat level fly in the face of what we know to be facts in the weeks and months leading up to the 2004 election. In the fall of 2004, al-Qaeda's no. 2, Ayman Zawahiri, released two audiotapes calling for attacks on the U.S.

In the wake of the bombing of Spanish trains in the days before the Spanish presidential election, these threats were taken seriously, as they should have been. As reported in The Washington Post on October 2, 2004:

An audiotape attributed to al Qaeda's second-in-command, Ayman Zawahiri, 3merged yesterday [October 1, 2004], calling for preemptive attacks against the United States and its allies, and urging followers to continue fighting "if we die or are arrested."

The tape, broadcast on the al- Jazeera satellite network, is the second message in less than a month to be attributed to Zawahiri, who is believed to be directing limited al Qaeda operations from hideouts along the Pakistan-Afghanistan border.

The recording stoked fears among some U.S. and European intelligence officials that the terrorist network is preparing a significant strike before the Nov. 2 presidential election. The FBI and other agencies this week launched an aggressive campaign of interviews and arrests aimed at thwarting such an attack.

On the Friday before the election, Osama bin Laden released a videotape with a similar message:

Osama bin Laden, injecting himself into the campaign four days ahead of presidential elections, said in a videotape aired Friday that the United States can avoid another Sept. 11 attack if it stops threatening the security of Muslims.

In the segment broadcast, the al Qaeda leader refrained from directly threatening new attacks, although he said "there are still reasons to repeat what happened."

Within hours of the release, John Kerry tried to use the videotape to his advantage, as reported by The Guardian, even though Kerry had not actually seen the videotape (reinforcing the image of Kerry as a buffoon):

Kerry was the first to use the tape to attack his opponent, appealing for Americans to show unity, but then quickly condemning Bush for missing an opportunity to capture bin Laden. 'I regret that when George Bush had the opportunity in Afghanistan and Tora Bora, he didn't choose to use American forces to hunt down and kill Osama bin Laden,' Kerry said.

Bush responded by lambasting Kerry's comments as 'shameful', and his aides followed up the attack. 'You would think there would be maybe 12 hours to let the American people absorb this [the video],' said White House spokesman Dan Bartlett.

Democrats at first said Kerry had not seen the tape when he made his comments. However, his aides held conference calls with reporters and in their turn attacked the Republicans for using the video as a political tool.

There is no evidence that raising the threat level [which was raised over the summer, not on the eve of the election] had any effect on the election. If anything, it was the release of audio and video taped threats, and John Kerry's foolish reaction, which swayed the public.

If the Bush administration had not raised the threat level and Spanish-style election-eve bombings had taken place, Ridge would have written a book complaining that the threat level was not raised.

Tom Ridge has revealed himself to be a fool in the likeness of Meghan McCain. And that's not a pretty picture, even if it does sell books.

Thursday, August 20, 2009

You would be hard-pressed to find a better example of how uncompromising the left-wing of the Democratic Party has become than the attempts to make sure the Obama administration and moderate Democrats do not compromise on the public option.

Jane Hamsher, one of the most prominent left-wing bloggers, rips into Obama and moderate Democrats in language which, if used by a conservative blogger, would result in accusations of wingnut hate-mongering and incitement:

But instead of repeating the mistakes of the Republicans, who allowed their representatives to line up behind George Bush and walk their party over the cliff, grass roots progressives are the ones who are taking control of the health care debate. They have rejected the discredited progressive leadership of the veal pen, and they are telling their progressive members of Congress that they will not accept a health care bill with a co-op "bait and switch."

Wow. Anything short of full-blown public health care amounts to Obama's "health care toenail clippings." Health care reform is becoming Obama's Iraq. Obama is leading the Left off a cliff, just like Bush did to Republicans.

To resolve the Mexican Standoff in which the Democrats find themselves over the health care restructuring bill, Harry Reid apparently has come up with the idea of splitting the bill. The popular insurance reform provisions would go to a full Senate vote subject to a filibuster, while the unpopular public option, mandates[*], and tax and spending provisions would be put through under a reconciliation procedure which requires only a simple majority.

This "solution" proves our point. There are aspects of health care reform which have popular and bipartisan support, some of which are included in the current draft bills and some of which are not. Some additional ideas would be to create a national market for private health insurance, to make it easier to purchase less expensive catastrophic insurance, and to simplify the rules on health savings accounts.

Passing these provisions will solve many if not most of the public's complaints about health care, without busting the federal and state budgets, destroying the private health sector, getting the IRS involved in enforcing health care mandates, imposing higher taxes, and getting the government further involved in our lives.

Splitting the bill may seem like the way forward for the Democrats to get nationalized health care, but in fact it will focus the public on the fact that we don't need to go there. Without popular health insurance reforms tied to the unpopular mandate, tax and spending provisions, the latter have little chance of success.

That's not to say Harry Reid can't push through the unpopular provisions, but he will not have the cover of the popular insurance reforms to justify the unpopular provisions. The wrath of the public in 2010 will be even greater once people realize they could have received most of what they wanted in health care reform without health care mandates, higher taxes, enormous budget deficits, rationing, and all the bureaucratic bungling which accompanies government-run anything.

Sounds like a plan.

[*The WSJ article lists mandates as being part of the insurance reforms which would be subject to a filibuster, but I can't see that provision actually getting 60 votes, so I doubt it would be included in a break out of the bill. Republicans would have plenty of political cover standing against mandates as would more moderate Democrats.]

Liberal Democrats say they will not vote for a health care restructuring bill without a public option. Less liberal Democrats say they will not vote for a health care restructuring bill with a public option.

Democrats need both groups to vote in favor of any bill in order for it to pass without substantial Republican support.

Democrats have created a Mexican Standoff, with each side pointing a philosophical gun at the other. Neither can move without giving up fundamental principles, and political credibility. Each is paralyzed with fear of failure, but unable to do anything because surrender on the public option is not a viable option.

This situation results from a lack of experience by Barack Obama. One of the criticisms of Obama during the campaign was that he never had run anything. And it is showing.

Failure to lead allowed the two factions to box themselves into positions diametrically opposed to each other. In an organization in which the chief executive has ultimate decision-making power, this would not be a problem.

But Obama does not have that power in this situation. The Senators and Congressmen do not work for him.

Don't get me wrong, I'm glad Democrats cannot unite on the disastrous health care restructuring proposals, reflected in the monstrous draft House and Senate bills. But let's be clear. The Democratic dilemma has nothing to do with Republicans. It is the result of mismanagement of the agenda by the Obama administration.

The white flag is flying over Camp Obama, which makes a pleasant change from the red flag that, metaphorically speaking, has been flying there since January 20. Barack Obama’s plan for socialised health care on the Stalinist model across the United States is now in full retreat. Not only will it not play in Peoria, it will not play anywhere....

There will be many more U-turns as reality overtakes Obama. His economic recovery plan, which cost nearly $1 trillion dollars and masked 9,000 pork barrels, has removed his halo for even quite gullible voters. This will be a one-term presidency.

I haven't seen a white flag yet. The aura is gone, along with the credibility and the superstar persona. But one thing Barack Obama has shown is that he keeps pushing forward regardless of long odds. The main thing holding him back is his fellow Democrats, and particularly the nutroots, who are at each other's throats over the public option.

If Obama cannot control his supporters and force a compromise among Democrats, then the white flag will fly. But we're not there yet. And three years is a long time.

Ed Morrissey at HotAir has the rundown on the faltering boycott of Glenn Beck's Fox News show. As predicted here, the failure of the boycott has numerous benefits.

What's more, the people pushing this boycott have stepped in it this time. There is no indication that Fox News will give in to the pressure. Fox News understands that this boycott nominally is against Beck, but really is against Fox News.

This is not the first boycott Fox News has broken. Remember when Democratic presidential candidates refused to appear on Fox News or allow Fox News to host a debate? Barack Obama eventually gave an interview to Bill O'Reilly, as McCain-Palin picked up steam.

In fact, Beck is planning a counter-attack against the organizers of the boycott when Beck returns from vacation next week. Beck and Fox News will use the boycott to expose the seamy side of the left-wing campaign against Fox News. The hunters will become the hunted.

Fox News will want to break this boycott to protect O'Reilly, Hannity and the franchise. The boycotters picked the wrong network.

Beyond that, the boycotters picked the wrong issue. Beck is not alleged to have made racist comments. This is not a Don Imus situation.

Rather, Beck allegedly made a false accusation of racism, which is so much a part of politics now that no one gets outraged anymore over it (except maybe me). So beyond the nutroots who have jumped on the bandwagon, the public is not going to be clamoring for Beck to be taken off the air. The boycotters picked the wrong issue.

Wrong network, wrong issue. Will this be the boycotters' Waterloo? Let's hope so, and that it also signals the end of the use of race as a political weapon.

Tuesday, August 18, 2009

Think Progress, the Democratic policy and media-watch organization, broke the story that someone in the audience at a health care town hall in Las Vegas shouted "Heil Hitler" at an Israeli giving a talk about the Israeli system. Needless to say, the video is being spread to show that health care protesters are crazy/racist/anti-Semitic.

But was this real or staged? I cannot say definitively, but something is wrong here. The video shows the woman who shouted "Heil Hitler," in the screen shot below:

Notice the shirt she is wearing? It is an Israel Defense Forces t-shirt, available on-line at Judaism.com (and possibly elsewhere):

Is this proof positive that this was a set-up? No. Does it raise suspicions? Definitely. How many people who shout "Heil Hitler" go around in an Israel Defense Forces t-shirt? How convenient that this shout was made only when the Israeli was being interviewed for television.

Given the imposters who have appeared at town halls to discredit health care protesters, anything is possible.

UPDATE: A video is available at ABC 13 in Las Vegas. The video shows the two individuals, but there is no mention of a "Heil Hitler" statement being made by the woman (the Think Progress video does not show who made the comment, and assumes it was the woman pictured). The woman is identified as Pamela Pilger, and the man as Samuel Blum.

The audio on the ABC 13 video also does not contain the "Heil Hitler" statement or show Blum conronting Pilger about the statement. (As as aside, Blum says he agrees there should be no health care support for illegal immigrants.) The ABC 13 web post on the town hall also makes no mention of a "Heil Hitler" statement.

Was the statement made, and who are these two people? Was it real or staged? Assuming this was not a set-up, why could an obvious supporter of Israel make such a statement; was it anti-Semitism, or just wrong-headed, like when blacks call other blacks the n-word? ... or mayby it's just a variation on the stupidity in which each side calls the other side Nazis, Godwin's law gone mad.

There is so much wrong with the House and Senate draft health care restructuring bills, that it is almost hard to know where to begin. I have already pointed out the new role of the Internal Revenue Service as enforcer of health care mandates, and the unprecedented taxation of people who do nothing. Here is Part 3 in the Health Care Tax Insanity Chronicles:

In the draft House bill, there is a 2.5% tax on the income (using a convoluted formula) of people who do not have acceptable coverage. In the draft Senate HELP Committee bill, however, the amount of taxation is not set.

Rather, the Senate gives the Secretary of the Treasury (who is in charge of the IRS) the power to come up with whatever amount of taxation (euphemistically called a "shared responsibility payment") he or she deems necessary to achieve compliance with the health care mandate. The bill provides for a new section 59B of the Internal Revenue Code (starting at page 103 of the bill; emphasis mine):

SEC. 59B. SHARED RESPONSIBILITY PAYMENTS.

(a) PAYMENT.—

(1) IN GENERAL.—In the case of any individual who did not have in effect qualifying coverage (as defined in section 3116 of the Public Health Service Act) for any month during the taxable year, there is hereby imposed for the taxable year, in addition to any other amount imposed by this subtitle, an amount equal to the amount established under paragraph (2).

(2) AMOUNT ESTABLISHED.—

(A) REQUIREMENT TO ESTABLISH.—Not later than June 30 of each calendar year, the Secretary [of the Treasury], in consultation with the Secretary of Health and Human Services and with the States, shall establish an amount for purposes of paragraph (1).

(B) EFFECTIVE DATE.—The amount established under subparagraph (A) shall be effective with respect to the taxable year following the date on which the amount under subparagraph (A) is established.

(C) REQUIRED CONSIDERATION.—In establishing the amount under subparagraph (A), the Secretary shall seek to establish the minimum practicable amount that can accomplish the goal of enhancing participation in qualifying coverage (as so defined).

Under this wording, the Secretary of the Treasury, i.e., the IRS, is the decision-maker with regard to the amount of the tax. The Secretary only need consult with the Secretary of Health and Human Services and the States.

The truly pernicious aspect of this provision is not that the Secretary of Treasury would pick some arbititrarily high amount just to raise revenue. Depending upon the nature of permitted judicial review, such an arbitrary decision likely would be overturned.

Rather, the very nature of the tax is unrelated to the cost of coverage. It is a tax to compel compliance. So the more people resist coverage, the more discretion the IRS would have to raise taxes to achieve compliance.

This is taxation unrelated to the federal budget needs or any rational cost of providing a federal government service. It is unprecedented taxation as law enforcement tool, and a complete abdication of Congressional accountability and responsibility.

The pressure put on advertisers to pull ads from the Glenn Beck show on Fox News has caused about a dozen major corporations to instruct their ad agencies to make sure their ads did not run on the show.

These advertisers never directed their advertising to Beck in the first place, but placed media buys at Fox News generally. As of now, there appears to be no revenue loss at Fox News. It is not even clear from the news reports whether these advertisers even constituted a significant portion of the ads run on Beck's shows.

The boycott stems from a remark Beck made calling Barack Obama a racist. The initiators of the boycott assert that Beck's statement amounts to a false charge of racism.

But false charges of racism are not new. The Obama campaign used false accusations of racism against Bill Clinton very effectively to disrupt Hillary's campaign in the primaries. Commentators on MSNBC and CNN regularly and falsely speak of conservatives, tea party attendees, and health care protesters as racist.

The use of false accusations of racism is so pervasive in our society that it has become part of the political landscape. Assuming Beck's statement were false, it was no more or less outrageous than what is heard daily on many networks (not to mention the blogosphere). If a false accusation of racism was so out of the mainstream, these corporations would have pulled all advertising from MSNBC and CNN long ago.

The advertisers are not reacting to Beck's speech, but to their own fears of being labelled racist. Call it the Al Sharpton phenomenon. There probably is no label a major corporation fears more than the "racist" label; and the fact that the label may be false and contrived for political gain makes no difference.

The Beck boycott is playing on the fears of major corporations that the failure to react to Beck's alleged false accusation of racism may itself be used to generate a false accusation of racism against the corporation. This circle of fear demonstrates the power of the race card in American society.

The boycott of the Beck show is a becoming a defining moment in the use of the race card and racial politics. If the boycott does not succeed in forcing Beck off the air, or changing his speech, this will be a great victory not just for Glenn Beck, but for Keith Olbermann and the flame throwers at more liberal networks. Freedom of speech protects everyone, a concept completely lost on the boycotters and the corporate image makers.

Indeed, if Fox News does not give in to pressure, it will be a victory for anyone who believes that the answer to offensive speech is more speech, not censorship.

Monday, August 17, 2009

As set forth in my prior post, IRS The New Health Care Enforcer, the new tax provisions in the Senate and House draft health care bills tax people for failing to obtain acceptable health coverage. These taxes are crucial to implementing a health care mandate (which Barack Obama said during the primary he was against) whereby the power to tax compels people to obtain coverage.

This tax, though, is unlike any other tax. Normally, the federal government taxes income, the purchase and sale of goods and services, and other economic behavior. To the extent the tax laws address non-economic behavior, i.e., one's mere existence, those laws grant credits or deductions (for example, for a dependent).

I am aware of no other tax resulting from one's failure to engage in economic activity. Under these draft bills, if you exist, the government taxes you unless you engage in economic activity (and the government may tax that activity as well, as in the case of expensive employer-provided health care plans).

Even the per capita taxes which exist in some states or municipalities do not tax the failure to engage in economic behavior; each person pays the same tax regardless of what they do or do not do.

What a bizarre concept is a tax to enforce a health care mandate. If you buy a computer at a store, you expect to pay a sales tax; but do you expect to pay the tax for not buying a computer? If you earn income at a job, you expect to pay taxes on the income; but do you expect to pay taxes for not working?

This is not strictly a constitutional issue. The prevailingview seems to be that such a tax would pass constitutional muster, although there certainly are arguments to the contrary.

Rather, this is a political issue. Does the American public truly understand the impact of allowing the federal government to tax individuals based on what such individuals do not do, the equivalent of a tax on one's mere existence?

Taxing inaction destroys our right to be left alone, which is one of the foundations of liberty in this country. The implications of such a tax as a tool of political coercion truly are revolutionary.

UPDATE 8/22/09: An interesting op-ed in The Washington Post arguing that a mandate is unconstitutional.

But can Congress require every American to buy health insurance?

In short, no. The Constitution assigns only limited, enumerated powers to Congress and none, including the power to regulate interstate commerce or to impose taxes, would support a federal mandate requiring anyone who is otherwise without health insurance to buy it.

As much as I oppose the various health care reforms promoted by the Obama administration and current Congressional leadership (and as much as I would like to see a more restrictive commerce clause jurisprudence), I do not find this argument particularly convincing.

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